Suicidal transition rates and their predictors in the adult general population: a repeated survey over 21 years in France.

Abstract

Background: The "suicidal transition" from ideation to an act has become a specific topic of research. However, rates in the general population, variations across time and risk factors are unclear.

Methods: Data were collected from the phone survey Baromètre Santé among 18-75-year-olds in France. Seven independent samples interviewed between 2000 and 2021 (total N = 133,827 people; 51.3% females) were questioned about suicidal ideation and attempts over the previous 12 months. Transition was calculated as the weighted ratio of attempt on ideation 12-month rates.

Results: Mean 12-month rates of suicidal ideation, attempts and transition were 4.7% (95% Confidence Interval (CI) (4.6-4.8)), 0.5% (95% CI (0.4-0.5)) and 7.7% (95% CI (6.8-8.6)), respectively. Transition rates varied between 4.5 and 11.9% across surveys. In multivariable analyses, higher transitions rates were associated with a previous suicide attempt (adjusted Odds Ratio (aOR) = 11.1 95% CI (7.9-15.6)); 18-25 vs 26-55-year-olds (1.8 95% CI (1.2-2.8)); lower vs higher income (1.7 95% CI (1.0-2.7); and lower vs higher professional categories (aOR around 1.9). No significant association was found with gender, education level, employment status, living alone, urbanicity, current major depression, daily smoking, weekly heavy drinking, cannabis use, and body mass index.

Conclusions: Most people with suicidal ideation do not attempt suicide. These findings emphasize the need to avoid generic terms such as "suicidality", and to increase research on suicidal transition to improve prevention and prediction. They may also inform the organization of suicide prevention in the general population.